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General NPI Number Information
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NPI Number | 1205858321
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Entity Type | Organization
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Legal Business Name | M & M PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 773 E ROUTE 70 SUITE E125
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City | MARLTON
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State | NJ
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Zip | 08053-2362
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Country | US
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Telephone | 856-988-7999
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Fax |
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Provider Business Mailing Address
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Address Line | 773 E ROUTE 70 SUITE E125
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City | MARLTON
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State | NJ
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Zip | 08053-2362
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Country | US
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Telephone | 856-988-7999
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/PARTNER
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Name | MRS. RUTH LYONS-MARCUS
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Credential | MPT
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Telephone | 856-988-7999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA00410400
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License Number State | NJ
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